Validation of Total Pelvic Floor Ultrasound

  • Research type

    Research Study

  • Full title

    Validation of Real Time Total Pelvic Floor Ultrasound in the Assessment of Pelvic Floor Dysfunction

  • IRAS ID

    166180

  • Contact name

    Andrew Williams

  • Contact email

    andrew.williams@gstt.nhs.uk

  • Duration of Study in the UK

    1 years, 9 months, days

  • Research summary

    Is Total Pelvic Floor Ultrasound a Reliable Tool for the Assessment of Women with Pelvic Floor Defaecatory Dysfunction?

    Pelvic floor dysfunction includes defaecatory dysfunction (difficulty opening bowels), urinary dysfunction, sexual dysfunction, incontinence and prolapse. 23.7% of women have at least one pelvic floor disorder and symptoms adversely affect quality of life.

    Pelvic floor disorders rarely occur in isolation and therefore global pelvic floor assessment is necessary for diagnosis and effective treatment planning.

    Gold standard imaging techniques are defaecating proctogram (X rays of bowels opening) and defaecating MRI (MRI of bowels opening). Proctography only images the rectum and entails x ray exposure. MRI images the entire pelvic floor but is inaccessible and expensive. Total pelvic floor ultrasound (through the vagina, perineum and rectum) is a feasible alternative which enables the dynamic, cheap, safe and accessible assessment of the entire pelvic floor. Currently, women presenting with pelvic floor defaecatory dysfunction undergo defaecation proctogram, total pelvic floor ultrasound and occasional MRI.

    The aim is to validate total pelvic floor ultrasound as a reliable tool for the assessment of pelvic floor defaecatory dysfunction such that it can be utilised for diagnosis and management planning. Proctography or MRI would only be necessary in select cases.

    This is a prospective case study over 24 months at St Thomas’ pelvic floor unit.

    20 asymptomatic volunteers will undergo total pelvic floor ultrasound and defaecating MRI to define normal anatomy and refine image interpretation.

    170 symptomatic patients will be routinely assessed (history, examination, anorectal physiology (testing pelvic floor muscles), total pelvic floor ultrasound and defaecating proctogram). 20 will also undergo defaecating MRI.

    The results will be used to assess the repeatability, reliability and accuracy of ultrasound. An algorithm will be written whereby total pelvic floor ultrasound is used as a screening tool for management planning and to determine if further investigations are necessary.

  • REC name

    London - South East Research Ethics Committee

  • REC reference

    15/LO/0271

  • Date of REC Opinion

    26 Mar 2015

  • REC opinion

    Further Information Favourable Opinion